Pretoria has developed contingency plans to sustain vital services, its health minister has said

South African Health Minister Aaron Motsoaledi says the country's world-leading HIV/Aids program "will not collapse" following the withdrawal of funding from the US President's Emergency Plan for Aids Relief (Pepfar) earlier this year.

This as the National Treasury injected R753 million into the programme with global partners pledging a further R600 million to support treatment and research.

Earlier this year, US President Donald Trump's administration announced it would halt all Pepfar funding, following previous global health aid cuts under the same administration. The decision by USAID to withdraw support has left a significant funding gap, particularly for countries like South Africa, where approximately 17% of the HIV/AIDS response was funded by Pepfar.

Presenting the Department of Health's 2025/26 budget in Parliament on Wednesday, Motsoaledi outlined the National Department of Health's three key priorities: strengthening the public health system in preparation for National Health Insurance (NHI), eliminating key diseases such as HIV/AIDS and TB, and implementing long-overdue reforms in the private health sector.

"There is no way we are going to allow the world's biggest HIV/AIDS Programme to collapse - never."

He described claims of a collapse as premature and inaccurate, insisting the department had developed clear plans to bridge the funding gap.

"In South Africa we seem to like the word 'collapse'. Every time something meets headwinds, it is said to have collapsed," he said.

Motsoaledi told Parliament, emphasising that despite funding cuts, government and partners are stepping in.

"We presented our plans to National Treasury and asked for help. At the same time we approached other funders, both domestic and globally."

Motsoaledi revealed that National Treasury had responded to the department's request for support by releasing R753,528,000.

He stated that of this amount, R590 million will be allocated to provincial HIV services through the District Health Programme Grant, R32 million to support national pharmaceutical supply chains, and R132 million to the South African Medical Research Council (SAMRC) for health research.

Treasury's funding comes alongside pledges of R100 million each from the Bill and Melinda Gates Foundation and the Wellcome Trust, on the condition that every R100 million is matched with R200 million in public funding.

"Treasury duly agreed," Motsoaledi said, resulting in a total of R600 million being made available to South African researchers over three years.

Motsoaledi also announced that South Africa will be among the first countries to roll out the long-acting HIV prevention injection, lenacapavir, following a new agreement by the Global Fund and Gilead Sciences.

"This is not just a scientific breakthrough - it is a turning point for HIV/AIDS," he said, quoting Global Fund Executive Director Peter Sands. He added, "We intend to be such a country," confirming that South Africa plans to offer lenacapavir to young women and others most at risk of infection.

Motsoaledi reaffirmed South Africa's commitment to the 2030 HIV elimination targets, stating that the country had made progress on the 95-95-95 UNAIDS goals, currently reaching 96-79-94. He said the department had launched a campaign in February to reach the 1.1 million HIV-positive people not yet on antiretroviral therapy.

"We are determined more than ever before to end the scourge of HIV/AIDS," said Motsoaledi.

The Minister also announced major infrastructure developments and capacity improvements aimed at relieving pressure on the overstretched public health system, which serves 86% of the population. In the 2025/26 financial year, the department will prioritise the hiring of 1,200 doctors, 200 nurses, and 250 other health professionals, an investment of R1.7 billion.

"National Treasury added R6.7 billion to try and reverse years of austerity measures which have crippled the Public Health System," Motsoaledi said.

In addition to new hires, R1.3 billion will be used to acquire 1.4 million items for hospitals, including beds, mattresses, and linen, while R1.4 billion will go towards permanently employing 27,000 community health workers previously contracted through NGOs.

Moreover, he also detailed plans to expand and modernise health infrastructure nationwide, including the construction of new hospitals, psychiatric facilities, and Community Health Centres. This is being guided by a digital planning tool known as HIPS (Health Infrastructure Portfolio System), which uses GIS data to identify gaps in health service delivery.

He warned that if South Africa fails to properly plan and invest in infrastructure, it could face a health system crisis akin to Eskom's loadshedding.

"We do not have any options but to plan in this manner," he said.

First published by IOL